Risk Factors of Drug and Alcohol Overdoses Inform Prevention and Treatment Services in Orange County

Problem: Over the past decade the rate of drug-induced overdose deaths in the United States has increased significantly, with about 100 people dying every day from drug-related overdoses. In Orange County, the overall rate of drug and alcohol overdose death has also increased – by 51% since 2000. Previous research has identified mental illness as a risk factor for substance abuse, and has been linked to drug-related overdose. This study examined factors that contributed to overdose hospitalizations and death in Orange County with the goal to better guide local prevention and treatment efforts.

Method: We analyzed hospitalizations as well as death records matched to data obtained from Coroner-investigated deaths between 2011 and 2013.

Findings: Roughly 45% of the nearly 600 annual overdose deaths were due to alcohol, while 55% were drug-related. Of drug-related overdoses, a large proportion of deaths were due to prescription medication misuse, often opioid pain relievers in combination with other substances. Additionally, roughly 60% of all overdoses were due to substance-related poisonings, while 40% were the result of a chronic substance use disorder. Importantly, 85% of the 5,400 annual overdose hospitalizations involved a mental illness diagnosis. Those most at risk included men, adults between the ages of 45-54, Non-Hispanic Whites, and those living along the more affluent coastal regions of the county.

Implications: The Health Care Agency offers several education, treatment and counseling services aimed at reducing the misuse and abuse of substances. Identifying those most at risk is essential to reducing the number of drug and alcohol poisonings and deaths.